Telerehabilitation and its effect on story retelling by adults with neurogenic communication disorders

Georgeadis, Amy C. and Brennan, David M. and Barker, Linsey M. and Baron, Christine R. Telerehabilitation and its effect on story retelling by adults with neurogenic communication disorders. Aphasiology, 18(5-7), 2004, pages 639-652.

Abstract

Background: Telerehabilitation (telerehab) is the method of using technology to provide rehabilitation services at a distance. The concept of delivering remote speech-language pathology (SLP) services using telerehab tools and techniques has been acknowledged for more than 25 years. While research has demonstrated videoconference-based telerehab to be a feasible, effective, and appropriate method for providing SLP services to a broad range of clients, studies have been primarily limited to technical feasibility or demonstration projects with relatively small sample sizes. There is an expressed need in the literature for controlled, randomised studies that track both quantitative outcomes of services delivered via telerehab as well as qualitative measures of satisfaction.

Aims: The purpose of the study was to measure performance of adults with acquired brain injury on a standardised SLP assessment conducted in both face-to-face (FF) and videoconference-based telerehab (T) settings. The objective was to determine if performance on the assessment, or subjective feedback from the participants, differed between settings.

Methods & Procedures: A total of 40 participants with a recent onset of brain injury--12 with traumatic brain injury (TBI), 14 with a left cerebrovascular accident (LCVA), and 14 with a right cerebrovascular accident (RCVA)--were enrolled in the study. Participants were asked to retell stories from the Story Retell Procedure (Doyle, McNeil, Spencer, Goda, Cotrell, & Lustig, 1998) in both FF and T settings. Responses from the stories were scored by the clinician using the percent information unit scoring metric (McNeil, Doyle, Fossett, Park, & Goda, 2001). Additionally, a survey tool was used to probe each participant's level of satisfaction and willingness to use telerehab services in the future.

Outcomes & Results: Across all participants, and within the TBI, LCVA, and RCVA groups, no significant difference in performance between the FF and T settings was found. Feedback from survey data demonstrated a high level of acceptance of the T setting. When compared to participants with LCVA or RCVA, however, participants with TBI were significantly more likely to show a lack of interest in future videoconferencing use.

Conclusions: Story-retelling performance by brain-injured adults was not affected by setting. Additionally, participants expressed a high level of interest in using videoconferencing in the future. These findings offer additional support for telerehab as a viable alternative mode of SLP treatment for survivors of stroke and TBI. Further research is needed to investigate the utility of telerehab for delivering services to clients with attention impairments as well as those with severe cognitive-communicative impairment, dysarthria, or aphasia.